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This morning with Steve Roberts on NPR
They had a doctor, Arthur Frank, M.D., of George Washington University
Hospital's Weight Management Program, answer questions on obesity on the Diane Rehm show. http://www.gwhospital.com/p11917.html He had some interesting comments. One was when he rebutted people who like to say, "It's all about calories in and calories out." when he said that isn't true: that individual metabolism and other things (such as age, hormones, illnesses, genetics, etc.) pay a large part in obesity. He also said that weight maintenance was primarily about exerting one's will over the "triggers" and bodily influences that can urge people to eat and overeat because in most people, these urges are built-in and will not go away. He said that people cannot just diet but have to re-order their way of eating and this lack of a new way of eating is why many people gain the weight back. And, he decried the impulse of our society to blame people who are overweight in a way they wouldn't blame people for other things, such as accidents or illnesses. Pat in TX |
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Pat wrote:
They had a doctor, Arthur Frank, M.D., of George Washington University Hospital's Weight Management Program, answer questions on obesity on the Diane Rehm show. http://www.gwhospital.com/p11917.html He had some interesting comments. One was when he rebutted people who like to say, "It's all about calories in and calories out." when he said that isn't true: that individual metabolism and other things (such as age, hormones, illnesses, genetics, etc.) pay a large part in obesity. He also said that weight maintenance was primarily about exerting one's will over the "triggers" and bodily influences that can urge people to eat and overeat because in most people, these urges are built-in and will not go away. He said that people cannot just diet but have to re-order their way of eating and this lack of a new way of eating is why many people gain the weight back. And, he decried the impulse of our society to blame people who are overweight in a way they wouldn't blame people for other things, such as accidents or illnesses. Pat in TX Thanks for the information. I greatly enjoyed reading the materials at the link you gave. I have attached some of the Q&A from the web page, as it reflects on big issues of percentage of people successful in A) Weight Loss and B) Life Changes To Keep WEight OFF.... And some other issues of general interest. I attempted to cut out the few "sales" oriented program details and less interesting (to me) pieces of information. Again, thanks for the link. I feel I learned a little more. Jim ------------ Q&A ------------- Selected ------- Q: Are there any special pills involved in this program? A: No megadose vitamins or minerals are used. No water pills, shots or secret preparations are used. The vitamins and minerals which are provided are standard preparations used in standard doses. They are carefully selected and balanced to meet the needs of patients on a low or very low calorie diet. Q: I want to keep my regular physician involved in my medical care. Can I do this? A: You should discuss this with your physician. Our staff will be happy to review the details of the program with your physician and keep your physician informed of your progress as you proceed. snip Q: Are there side effects or risks associated with this program? A: Yes. Any weight loss program will produce some occasional side effects. In either the food-based or the formula program, the side effects are infrequent and are usually well tolerated. Almost all of the side effects are resolved within the first two weeks of the program. Our staff will review and provide you with a summary of the potential side effects when you start the program. It should be emphasized that we have encountered no serious or significant problems in more than 20 years and in treating over 6,000 patients. We have had no patients who have required hospitalization or experienced unmanageable complications because of the program. The potential side effects of these weight loss programs appear to be less frequent and less troublesome than the risks of untreated obesity. A summary of possible side effects is provided to all patients. You may call our office and request that a copy be mailed to you. Q: Will I be able to continue my regular activities while I am on this program? A: Yes. Patients are urged to continue their regular activities including employment and exercise programs. Patients on either the food-based or formula program ordinarily feel entirely well. **************** Q: How successful is this program in getting people to lose weight? A: About 75% of the patients who start the program will lose more than half of their excess weight. About 45% will reach a goal weight. This compares favorably with traditional programs for weight loss which ordinarily report that less than 5% of their patients lose 40 or more pounds. ***************** Q: What about long-term maintenance? How good is this program at assuring that I can maintain my weight loss? A: No program can assure you that you can maintain your weight loss. The best we can hope is that you will become familiar with the techniques of maintenance and will be able to incorporate these into your own personal practices for sustaining your weight loss. Part of the program includes a very comprehensive effort directed at assisting people in maintaining their loss. No one should be unrealistic about the difficulty of weight maintenance. No one should expect that obesity can be cured. Our goal is that each patient will lose weight, learn new techniques for maintaining the weight loss and that the quality of life will be improved during the time that control can be maintained. snip Q: So much of my success in weight loss depends upon the assistance of my husband (or wife) and yet there often seems so little that he (or she) can do. Is there any way in which my spouse can be involved and become familiar with the problems I am having? A: Yes, One of the sessions in our groups is oriented to family members. Concerned individuals in your family are urged to attend. We have organized special meetings for spouses and have found them to be remarkably effective. We will continue to conduct spouses’ meetings. ************************************** Q: How can I not be hungry while eating so little food on a formula program? A: We are not certain why people are no longer hungry, but it is clear that hunger is rarely a problem. Most patients recognize that significant problems with hunger are not an issue while they are on this formula program. Although patients will occasionally feel the sensation of wanting to eat, they usually recognize that there is no need to do so. There is no clear metabolic explanation for the absence of hunger. ************************************ snip Q: My experience with psychologists and psychiatrists has been negative and I am reluctant to participate in the group sessions. Is it an obligatory part of the program? A: We strongly believe that the group sessions are an important and intrinsic part of the process of losing weight and of maintaining the weight loss. Although there is no absolute requirement that every patient attend the group sessions, we have found that patients who participate in the classes and groups are about twice as likely to succeed in their weight losing efforts as those who decline to participate. Because our charges are based on the assumption that all patients participate in groups, there is no reduction in the fees for patients who choose not to do so. Q: About how rapidly can I expect to lose my weight? A: If you assume an average rate of weight loss on a formula program, you will lose about 1/4 of your body weight in three to four months and about 1/3 of your body weight in four to five months. You can make individual calculations by assuming that you will lose about nine or ten percent of your body weight in the first month and about seven or eight percent of your then-current weight in each subsequent month. The rapidity of weight loss on a food-based program depends on the particular program used. Occasionally patients reach a plateau in their weight loss. This always represents water retention in compliant patients. Water retention and shifts in water balance are totally unrelated to the rapidity of the fat loss. Fat is lost at a steady rate regardless of any factors related to water balance. Q: How many calories will I be able to eat when I resume a regular diet? A: This varies substantially from one person to another. We will develop an individualized set of recommendations about your food and dietary patterns before you are ready to reintroduce food. Q: Why bother? 1 know I can lose weight, but I’ve lost and gained weight so many times that I am very pessimistic about my ability to sustain a normal weight. Is it worthwhile to try another diet? Isn’t it dangerous to bounce up and down? A: Most chronic diseases have a fluctuating pattern of symptoms and disability. Obesity is not different. Techniques for assured long-term control do not exist, but many good techniques can be helpful for a patient who is willing to maintain a continuing, deliberate, probably life-long effort. Most patients who have not been able to maintain control have never participated in a comprehensive program or have never learned appropriate maintenance techniques. Many of these patients have never been at a comfortable normal weight and even after reducing their weight, they continue to struggle with old and tired procedures for dieting to lose those last few pounds. These patients have never truly tried a maintenance program. Even if control is not perfect and some weight is regained, many patients recognize that they are significantly more comfortable, often for long periods of time, when they can maintain their weight below their maximum. Again, as with most chronic diseases (diabetes and arthritis are good examples), the obese patient is clearly healthier and more comfortable when under control even if there is a possibility of a recurrence of loss of control. It has recently been suggested that “yo-yo” dieting damages or irrevocably changes the already slow metabolism which is often a part of the problem for many obese patients. Careful studies have refuted these claims. All patients on any diet will slow their metabolism while they lose weight. Metabolism recovers, however, with stabilization and maintenance of weight loss. There is no permanent change in metabolism. No one suggests that weight cycling is a prudent form of management. The issues surrounding fluctuating weight loss emphasize that the complex task of weight loss should be done carefully so as to avoid the possibility of weight cycling regardless of any impact this might have upon metabolism. snip |
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